Hi Friends, it feels great speaking to you after a long gap of many weeks. This time we will be having a discussion on a very common condition affecting wrists. It is called as Carpal Tunnel Syndrome (CTS).
Most commonly it occurs in people who utilize their wrists joints in repetitive movements such as computer programmers, typewriters, teachers and washer men. It is also seen in pregnancy, rheumatoid arthritis, diabetes, hypothyroidism or fractures. To diagnose carpal tunnel syndrome Phalen’s test or Tinel sign is used. Sometimes studies such as Electromyograpy (EMG) or Nerve conduction velocity (NCV) tests are done to see the extent and severity of damage to the median nerve. Let us first look at the anatomy of wrist joint to know how CTS is caused.
The wrist is surrounded by a band of fibrous tissue that normally functions as a support for the joint. The tight space between this fibrous band and the wrist bone is called the carpal tunnel. The median nerve passes through the carpal tunnel to receive sensations from the thumb, index, and middle fingers of the hand. Any condition that causes swelling or a change in position of the tissue within the carpal tunnel can squeeze and irritate the median nerve. Irritation of the median nerve in this manner causes tingling and numbness of the thumb, index, and the middle fingers also called as “carpal tunnel syndrome.” Tendon inflammation resulting from repetitive work, such as uninterrupted typing, can also cause carpal tunnel symptoms.
People with carpal tunnel syndrome initially feel numbness and tingling of the hand in the distribution of the median nerve (the thumb, index, middle, and part of the fourth fingers). These sensations are often more pronounced at night and can awaken people from sleep. The reason symptoms are worse at night may be related to the flexed-wrist sleeping position and/or fluid accumulating around the wrist and hand while lying flat.
Treatment usually includes rest, immobilization of the wrist in a splint, corticosteroid injections and occasionally surgery. Those whose occupations are aggravating the symptoms should modify their activities. For example, computer keyboards and chair height may need to be adjusted to optimize comfort. These measures, as well as periodic resting and range of motion stretching exercise of the wrists can actually prevent the symptoms of carpal tunnel syndrome that are caused by repetitive overuse. Other treatments include Anti inflammatory medicines, wrist brace and local steroid injection in carpal tunnel.
Exercises for CTS: Given below are series of stretches to the median nerve through movement of fingers, thumb and wrist.
Also, whenever you are sitting for a long time on your desktop please remember to do the following exercises. Repeat each of them 10 times after every one hour of work. You can do them while sitting or standing.
Bye for now…see you soon with another interesting topic.
Kiran Mahadik, PT